Clinical and social aspects of the quality of life in patients with Parkinson’s disease

Abstract

Parkinsons disease (PD) is an age-related neurodegenerative disease associated with the loss of dopamine-producing neurons in the substantia nigra. The disease is manifested by motor disorders and a variety of non-motor symptoms (NMS). NMS may reduce the quality of life (QoL) of people with Parkinsons disease (PD) more than motor manifestations, but their ultimate contribution has not been fully established. AIM. To determine the impact of motor, cognitive and affective disorders and social factors on the quality of life of patients with PD in the Republic of Sakha (Yakutia). MATERIAL AND METHODS. The study included 35 patients with PD, HoehnYahr stage 13 (60% women and 40% men), mean age 64.42.0 years. We used scales: UPDRS, MoCA, HADS, NMSQuest, Epward Sleepiness Scale, PDQ39. The analysis of clinical signs and social factors in the studied group of patients was carried out. RESULTS. The decrease in QoL was moderately associated with disease stage (r=0.56, p=0.009), the severity of motor manifestations (r=0.65, p 0.001) and the total number of NMS (r=0.46, p=0.008). Age and disease duration did not affect on QoL. The decrease in QoL was influenced by the presence of depression (r=0.83, p 0.001), anxiety (r=0.69, p 0.001) and cognitive decline (r=0.46, p=0.008). Low levels of QoL were found in individual PD patients and in people with disabilities. QoL was not influenced by ethnicity, gender, employment or education. Three groups of patients with PD were identified: those with mild, moderate and severe decrease in QoL. Their clinical and social portraits are presented. CONCLUSION. The dependence of the quality of life of patients with PD on the form of the disease, the stage of the disease, the severity of depression, social factors has been demonstrated, which requires attention not only from neurologists, but also from psychotherapists and social workers.